Left Atrial Dissection Induced by Coronary Sinus Catheter-Related Injury.

We present a unique case of left atrial (LA) dissection in a 46-year-old man following aortic dissection surgery. The LA dissection was attributed to coronary sinus catheter-related injury. This report highlights the importance of recognizing this rare complication and the crucial role of transesophageal echocardiography in its diagnosis. We discuss the pathogenesis, diagnostic criteria, and management strategies for LA dissection.

DSANet: Dual-Branch Shape-Aware Network for Echocardiography Segmentation in Apical Views.

Echocardiography is an essential examination for cardiac disease diagnosis, from which anatomical structures segmentation is the key to assessing various cardiac functions. However, the obscure boundaries and large shape deformations due to cardiac motion make it challenging to accurately identify the anatomical structures in echocardiography, especially for automatic segmentation. In this study, we propose a dual-branch shape-aware network (DSANet) to segment the left ventricle, left atrium, and myocardium from the echocardiography. Specifically, the elaborate dual-branch architecture integrating shape-aware modules boosts the corresponding feature representation and segmentation performance, which guides the model to explore shape priors and anatomical dependence using an anisotropic strip attention mechanism and cross-branch skip connections. Moreover, we develop a boundary-aware rectification module together with a boundary loss to regulate boundary consistency, adaptively rectifying the estimation errors nearby the ambiguous pixels. We evaluate our proposed method on the publicly available and in-house echocardiography dataset. Comparative experiments with other state-of-the-art methods demonstrate the superiority of DSANet, which suggests its potential in advancing echocardiography segmentation.

Short-term and long-term outcomes of bailout versus planned coronary rotational atherectomy.

The goal of this study was to compare in-hospital and long-term events between bailout rotational atherectomy (RA) and planned RA. In this retrospective study, All patients who underwent percutaneous coronary intervention (PCI) using RA at Nanjing Drum Tower Hospital from November 2011 to December 2018 were enrolled in this study. Planned RA was defined as RA performed immediately before balloon pre-dilation, while bailout RA was defined as RA after failure to expand the balloon or perform any other procedure. In-hospital and long-term major adverse cardiac events (MACE, defined as cardiac mortality, myocardial infarction (MI), target vessel revascularization (TVR) and stroke) were compared between the two groups. After statistical analysis, a total of 211 patients underwent PCI with RA during the study period: 153 in the planned RA group, and 58 in the bailout group. The incidence of coronary dissection was significantly higher in the bailout RA group than in the planned RA group (22.4% vs. 6.5%, P = 0.001). However, no significant difference in in-hospital MACE was found between the two groups (12.1% vs. 13.7%, P = 0.752). There was no difference in all-cause mortality (9.1% vs. 12.5%, P = 0.504) or long-term MACE (13.8% vs. 17.1%, P = 0.560) between the groups. Bailout RA was associated with a significantly longer procedural time (139.86 ± 56.24 min vs. 105.56 ± 36.71 min, P < 0.001) than planned RA. Therefore, compared with bailout RA, planned RA is associated with shorter procedural time and reduced incidence of coronary dissection, with no difference in MACE or mortality.